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Threshold Effects in the Relationship Between Serum Non-High-Density Lipoprotein Cholesterol and Metabolic Syndrome.

ABSTRACT: Background:Previous studies have suggested that the non-high-density lipoprotein cholesterol (non-HDL-C) is strongly associated with metabolic syndrome (MetS); however, the explicit relationship between them has not yet been clarified. The aim of this study was to reveal the explicit association between the non-HDL-C with MetS. Methods:The present study was based on a cross-sectional study, which was carried out in Spain. A total of 60,799 workers were recruited between 2012 and 2016. Anthropometric parameters and blood indices (lipid profile and fasting blood glucose) were collected. Participants were divided into the MetS group or the non-MetS group based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III. The relationship between serum non-HDL-C and the risk of MetS was evaluated using multivariate regression analysis, piece-wise linear regression analysis, smooth curve fitting and threshold saturation effect analysis after adjustment of potential confounders. Results:The risk of developing MetS increased with increasing non-HDL-C level. However, this association was only presented in the range of the non-HDL-C concentrations from 118 mg/dl to 247 mg/dl after adjusting for potential confounders. When compared to lower non-HDL-C level (<118 mg/dl), higher levels of non-HDL-C (118-247 mg/dl and >247 mg/dl) were related to higher incidence of MetS, with adjusted odds ratio (95% confidence interval) of 3.08 (2.77, 3.42) and 17.18 (14.29, 20.65), respectively (P for trend <0.05). Conclusion:Higher serum non-HDL-C level was associated with increased MetS incidence; however, significant threshold saturation effects were observed when the non-HDL-C level <118 mg/dl or >247 mg/dl.

SUBMITTER: Wang S

PROVIDER: S-EPMC6890221 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Threshold Effects in the Relationship Between Serum Non-High-Density Lipoprotein Cholesterol and Metabolic Syndrome.

Wang Saibin S Tu Junwei J Pan Yibin Y

Diabetes, metabolic syndrome and obesity : targets and therapy 20191129

<h4>Background</h4>Previous studies have suggested that the non-high-density lipoprotein cholesterol (non-HDL-C) is strongly associated with metabolic syndrome (MetS); however, the explicit relationship between them has not yet been clarified. The aim of this study was to reveal the explicit association between the non-HDL-C with MetS.<h4>Methods</h4>The present study was based on a cross-sectional study, which was carried out in Spain. A total of 60,799 workers were recruited between 2012 and 2 ...[more]

PMID: 31819575

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Project description:Background and objectiveKlotho is a protein that is closely related to human aging. Soluble Klotho (S-Klotho) is a circulating protein, and its level decreases in response to systemic inflammation. The relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR), an emerging inflammatory index, and S-Klotho concentrations is still unclear. In addition, the mean platelet volume has been confirmed to have a significant negative association with S-Klotho concentrations, but the relationship between the platelet count (PC) and S-Klotho concentrations has not yet been reported.MethodsData from individuals who participated in the National Health and Nutrition Examination Survey (NHANES) during the five cycles from 2007 to 2016 were retrieved for analysis. Linear regression, two-piecewise linear regression, and restricted cubic spline (RCS) methods were used to analyze the associations of the PHR index and its components with S-Klotho concentrations. In addition, subgroup analysis and effect modification tests were conducted.ResultsA total of 11,123 participants (5463 men (48.17%)), with an average age of 56.2 years, were included. After full adjustment, the S-Klotho levels of participants in the highest quartile group of PHR (β: -51.19, 95% CI: -75.41 to -26.97, P < 0.001) and the highest quartile group of PC (β: -72.34, 95% CI: -93.32 to -51.37, P < 0.0001) were significantly lower than those in their respective lowest quartile groups, and a significant downward trend was presented among the four groups (P for trend < 0.05, respectively). However, high-density lipoprotein cholesterol (HDL-C) concentrations were not significantly associated with S-Klotho concentrations. RCS revealed that the PHR and PC were nonlinearly associated with S-Klotho concentrations; two-piecewise linear regression revealed that the inflection points were 175.269 and 152, respectively, and that these associations slightly weakened after the inflection point. According to the subgroup analysis, liver disease status enhanced the association between the PC and S-Klotho concentrations.ConclusionsBoth the PHR and PC were significantly negatively associated with S-Klotho concentrations, and these associations were nonlinear. There was no significant association between HDL-C and S-Klotho concentrations. Liver disease status enhances the negative association between the PC and S-Klotho concentrations, and the specific mechanism deserves further exploration.

Project description:There is accumulating evidence that serum levels of non-high-density lipoprotein cholesterol (non-HDL-C) are a more accurate predictor of cardiovascular outcomes when compared with low-density lipoprotein cholesterol. However, we recently found that higher serum concentrations of triglycerides are associated with better outcomes in patients undergoing hemodialysis. Therefore, we hypothesized that the association of serum levels of non-HDL-C (which includes triglyceride-rich lipoproteins) with outcomes may also be different in patients undergoing hemodialysis when compared with other patient populations. We studied the association of baseline and time-dependent serum levels of non-HDL-C with all-cause and cardiovascular mortality using Cox proportional hazard regression models in a nationally representative cohort of 50 118 patients undergoing incident hemodialysis from January 1, 2007, to December 31, 2011. In time-dependent models adjusted for case mix and surrogates of malnutrition and inflammation, a graded inverse association between non-HDL-C level and mortality was demonstrated with hazard ratios (95% confidence intervals) of the lowest (<60 mg/dL) and highest (≥160 mg/dL) categories: 1.88 (1.72-2.06) and 0.73 (0.64-0.83) for all-cause mortality and 2.07 (1.78-2.41) and 0.75 (0.60-0.93) for cardiovascular mortality, respectively (reference, 100-115 mg/dL). In analyses using baseline values, non-HDL-C levels <100 mg/dL were also associated with significantly higher mortality risk across all levels of adjustment. Similar associations were found when evaluating non-HDL/HDL cholesterol ratio and mortality, with the highest all-cause and cardiovascular mortality being observed in patients with decreased non-HDL/HDL-C ratio (<2.5). Contrary to the general population, decrements in non-HDL-C and non-HDL/HDL cholesterol ratio were paradoxically associated with increased all-cause and cardiovascular mortality in patients undergoing incident hemodialysis. The underlying mechanisms responsible for these associations await further investigation.

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Threshold Effects in the Relationship Between Serum Non-High-Density Lipoprotein Cholesterol and Metabolic Syndrome.

Publications

Threshold Effects in the Relationship Between Serum Non-High-Density Lipoprotein Cholesterol and Metabolic Syndrome.

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